Can psychological measures be used to predict injury?
It is accepted that throughout an athlete’s career they will encounter injury setbacks. But it does appear, at least anecdotally, that some athletes experience more injuries than others. I’m sure any sports fan could come up with an example of an athlete who has had seemingly endless injury problems. Without wishing to name any names, I can think of a certain footballer who has had a torrid time with injury. Indeed, according to the physioroom.com from the beginning of 2011 to today he has had 24 separate injuries, all of varying severity. Whilst there are undoubtedly a range of factors ranging from physical to genetic that determine injury, this article will focus on the psychological factors that may influence injury risk.
Andersen and Williams (1988) first proposed a model of stress and athletic injury, which has since been revised (Williams & Andersen, 1998) and extended (Petrie & Perna, 2004). Essentially the model proposes that certain psychological factors predispose an athlete to become more stressed when under pressure. This stress response leads to physiological and attentional changes that can increase one’s propensity to injury. The psychological factors included in the model are: personality, history of stressors, and coping resources. Research into each of these factors has identified more specifically what variables are important (see Johnson, 2007 for a review). However, it should be noted that the research has been carried out in a variety of contexts and using a range of sports. Whether or not certain factors are more or less relevant in certain sports is yet to be clarified.
Regarding personality, the characteristics of competitive trait anxiety, somatic trait anxiety, mood states, perfectionism, self-confidence/ self-esteem and mistrust have all demonstrated relationships with the stress response and subsequent injury risk. The history of stressors category is composed of daily hassles and life event stress. Whilst it is unclear whether daily hassles such as being late or unexpected arguments have an effect in this model, life event stress does appear to be influential. These major life events like moving to a new city, divorce, or a new baby can be linked to increased stress and propensity towards injury. Finally, coping resources refer to factors that may help an athlete to cope with stress, such as social support from family and friends. An athlete’s coping resources does appear to be linked to subsequent injury.
To try and give you a better idea of what I am talking about let’s put this into an example. Say an athlete is about to compete in a major final. Their personality is high in trait anxiety and perfectionism and they have recently divorced from their partner and had to move into a new house. Moreover, they are don’t have many friends in this area and their family lives far away. All these factors, coupled with the high pressure of the competition leads to the player becoming highly stressed.
That they will be stressed in this situation is unsurprising, but why should being stressed increase the likelihood of a player getting injured? To explain one must examine the changes that can occur under stress. One proposed change is an increased in generalised muscle tension. This not only can mean that the muscles are more likely to rip or tear but also it restricts the athletes’ ability to move easily. Therefore, if an opponent is trying to tackle them, they may be less able to avoid it. Another change during stress involves a narrowing of the visual field. This restricts the view of the periphery which may mean the player is less likely to spot a dangerous situation, such as the opponent arriving to tackle them. The final change included in the model is increased distractibility. It is hypothesised that when under stress, people are more prone to focus on distracting stimuli. Once again this increases the possibility that an athlete may fail to notice a potentially injurious situation.
It is important to remember that the model does not claim to be 100% accurate in predicting injury and it does not mean that stressed athletes will get injured. The very nature of elite competition is stressful and clearly not every athlete competing at this level is injured. However, the model does have potential to identify athletes who are most at risk of injury and give ideas about how to help them, for instance by increasing their coping resources.
Andersen, M. B., & Williams, J. M. (1988). A model of stress and athletic injury: Prediction and prevention. Journal of Sport and Exercise Psychology, 10(3), 294-306.
Johnson, U. (2007). Psychosocial antecedents of sport injury, prevention, and intervention: An overview of theoretical approaches and empirical findings. International Journal of Sport and Exercise Psychology, 5(4), 352-369.
Petrie, T. & Perna, F. (2004). Psychology of injury: Theory, research, and practice. In T. Morris & J. Summers (Eds.), Sport psychology: Theory, applications, and issues (pp. 547-571). Australia: Wiley.
Williams, J. M., & Andersen, M. B. (1998). Psychosocial antecedents of sport injury: Review and critique of the stress and injury model'. Journal of Applied Sport Psychology, 10(1), 5-25
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